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APPLICATION-MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> I,the Owner/Agent agree,to defend,Indemnify,and hold harmless the County and Its agents,officers and employees from any claim,action or <br /> proceeding against the OwnerlAgent's project. <br /> 1,further, certify under penalty of perjury that I am(check one): <br /> z3 Legal property owner(owner Includes partner,trustee,trustor,or corporate officer)of the property(s)Involved In this <br /> application,or <br /> O Legal agent(attach proof of the owner's consent to the application of the property's Involved In this application and <br /> have been authorized to file on their behalf.,and that the foregoing application statements are true and correct. <br /> Print Name: 44r-4-- y' . SiyJi174 Signature: ,2 —z ,� Date: S� a Z <br /> Print Name: A-- c a.. n < Signature: — Date: <br /> Pr1nt.Nam•: 11pnature: Darer <br /> Print Name: signature: UNTO: <br /> Name: S/ nature: <br /> Date: <br /> HI HOIUUEAPP rOIW �t V, -10-01 ( Hol <br />